经历了可植入心脏器件失败除的患者,尽管有程序管理,但仍然面临高风险
Nathaniel Christian-Miller1, Muazzum Shah1, Kelly Arps1
1Division of Cardiovascular Medicine, Department of Electrophysiology, University of Michigan, Ann Arbor, Michigan, USA.
Journal of cardiovascular electrophysiology
|March 9, 2026
概括
在植入式心脏除器 (ICD) 的患者中,失败的除治疗发生在2.8%的病例中. 运营和非运营管理策略都产生了类似的长期结果,尽管重复失败仍然很高.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 医疗器械 医疗器械
背景情况:
- 植入式心脏除器 (ICD) 患者的失败除治疗可能源于患者或设备因素.
- 在失败的除治疗后的管理策略需要进一步阐明.
研究的目的:
- 研究使用可植入心脏器件进行失败的除治疗的患者的管理方法和结果.
- 在这个患者队列中,比较手术与非手术的管理策略.
主要方法:
- 一个单一中心的队列研究包括患有ICD的患者,这些患者经历了不成功的除疗法.
- 分析了人口和设备特征.
- 对于经过手术治疗的患者和非手术治疗的患者,评估了没有重复失败的器械治疗的生存率.
主要成果:
- 在1449名ICD患者中,有40人 (2.8%) 接受了不成功的除疗法.
- 管理包括设备重新编程,抗失常药物,保守治疗,添加或脉冲发生器更换.
- 经过平均2.4年的随访后,55%的人经历了复发性静脉动,15%的人重复失败了除器治疗.
- 在操作和非操作管理组之间没有观察到反复出现的失败冲击的显著差异.
结论:
- 在ICD患者中,失败的除疗法的发生率为2.8%.
- 运营和非运营管理方法都导致了可比的长期结果.
- 很大一部分 (15%) 的患者经历了反复失败的除治疗,这表明持续的挑战.
相关概念视频
Cardiopulmonary Resuscitation III: AED Use
998
Introduction to AEDAn Automated External Defibrillator (AED) is a portable medical device that analyzes the heart's rhythm and, if necessary, delivers an electrical shock to help the heart re-establish an effective rhythm during sudden cardiac arrest (SCA). SCA occurs when the heart suddenly and unexpectedly stops beating, leading to a loss of blood flow to the brain and other vital organs. In such emergencies, time is of the essence, and using an AED, combined with Cardiopulmonary...
998
Disturbances in Heart Rhythm
3.4K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
3.4K
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
753
Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
753
Dysrhythmias VI: Management of Dysrhythmias
553
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
553
Cardiopulmonary Resuscitation IV: Pharmacological Management
1.1K
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
1.1K
Cardiomyopathy II: Dilated Cardiomyopathy
695
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
695


